Mentalization in the Psychosis Continuum: Current Knowledge and New Directions for Research and Clinical Practice

Book excerpt: Impairments in mentalizing - the capacity to utilize mental state information to understand oneself and others - have consistently been identified across the developmental continuum of psychosis expression, from the premorbid and prodromal stages to its clinical forms. Mentalizing difficulties in psychosis have been investigated using an array of different methodologies, including novel experimental tasks, narrative assessments, self-report measures, as well as neuroscientific and computational methods. These studies have primarily examined how mentalizing disturbances relate to symptom dimensions and functional outcomes in clinical samples, as well as the transition to clinical psychosis among those who are at increased risk. More recently, clinical adaptations of mentalization-based treatments (MBT) and other psychotherapeutic approaches with a focus on supporting people suffering with psychosis reflect on their own and others’ mental states, such as Metacognitive Reflection and Insight Therapy (MERIT), have been reported in the literature.